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left breast issues and lots of questions

Hello,

I have a preemie and am pumping to bottle feed or tube feed him at this point. He’s a 34 weeker now four weeks old. We practice bf, but our main goal is for him to gain weight right now.

My supply is really low. I can only pump about 30 ml per session total. My right breast gives me twice what the left puts out and the left breast doesn't really get started until about 3 minutes after the right. I massage my breast during pumping and I hand express after to try and empty them.

I'm trying very hard to pump every 3 hours, but I hit a wall and became completely exhausted with my preemie. For the past three or four days, I've missed a few pumps and have gone without pumpuing for 5 or 6 hours a few times because I've slept through them. Once I think I went 7 hours.

Have I permanently jeopardized my already low supply by going without pumping so many times? How long does it take for your supply to disappear?

After I pump, when would i have milk again for my baby? If I pump and he happens to wake a half hour or so later, will I have milk for him?

How can I tell if my breasts are empty? All I can feel right now is a tingling sensation in my nipples every three hours or so. I can sort of tell they're full, but I can't tell when they're empty.

How long should i pump? Right now, I'm doing 15-20 minutes but if I can squeeze out a few more drops I'll work at it for another 5 or 10. Is it supposed to take this long?? Can I damage my milk ducts by over massaging or expressing?

Should I power pump just the left breast? Is my left breast abnormal? Should I not worry about it?

If I refrigerate my milk and then use some of it, can I re-refrigerate the rest for later? or, if my preemie doesn't take the full bottle of breast milk, can I refrigerate it for later? If I warm up my breast milk in the bottle how long can it sit out and be used?

Re: left breast issues and lots of questions

Congratulations on the birth of your son!

I agree with the previous poster that contacting a local Leader is a good idea. I also can imagine that caring for your preemie, pumping, eating and sleeping may be taking all the time and energy you have right now, and the thought of talking on the phone is exhausting.

I'll do my best to answer...

It makes sense that your first priority is weight gain, then breastfeeding.

Yes, it is perfectly normal that one breast gives more milk than the other breast when you pump. You can think of it as different personalities. It doesn't necessarily mean that your baby will get less milk from one breast than from the other.

Have you tried massaging your breasts *before* pumping? Many mothers find that helpful.

When you hand express after pumping, do you get any milk? If you're not getting much, you could consider dropping that part of your pumping routine. That would cut down your pumping time a little bit.

Don't beat yourself up for sleeping through pumping sessions occasionally. You're beyond exhausted from four weeks of caring for a premature baby. You're doing the best you can. Yes, it is ideal to pump every 2 to 3 hours. No, you have not permanently jeopardized your supply. It is always possible to build it up.

You said your doctor prescribed medication to help increase milk production. What was prescribed? Have you started it? Have you noticed an effect yet?

I don't know how long it would take for a mother's milk supply to completely disappear, but yours will not completely disappear because you are pumping and putting your baby to the breast occasionally (right?).

Your breasts are making milk as your nurse your son. So, even if you have pumped and then he wants to nurse 30 min. later, there will be some milk there already, and your amazing super power of making milk is happening as he nurses.

Some mothers can tell that their breasts are "empty", and some cannot. I say "empty" because the breasts are never truly empty. During pumping, when you notice the flow dwindling to drops, you can continue pumping to try for a second let-down, and then stop when it dwindles to drops again.

Re: left breast issues and lots of questions

Do not despair....and this too shall pass! Just don't give up! I also had a preemie, a 35 weeker, and we had some difficulties, but we got through them all and enjoy a wonderful breastfeeding relationship now. Just make sure you're getting the support you need. In the NICU where my daughter stayed, there was a lactation consultant that dealt specifically with preemie/needy babies. I would definitely see if there is one you can speak with in your area!! That helped me the most.

Also, are you using a hospital grade pump, instead of one you can buy at the stores? They work better for milk production when your baby is not at the breast at all. I rented one from my hospital where I gave birth, and rented on a monthly basis until we had breastfeeding well-established. There is definitely a difference.

And make sure you do sleep. You need it even more than the average new mom with the stresses of a preemie. You are not permanently damaging your milk supply. The beauty of our bodies is they adapt according to the needs of our children.

As far as milk use/storage goes, read the article. In the hospital, whatever milk the baby doesn't drink, they throw out. I think once a baby is well enough to be home, you can keep your milk even after the baby as drank from the bottle (I think it's like 7-8 days)....just be extra cautious that your bottles and pump parts are sterile.

And it's totally normal for milk to be different in each breast. I still pump half the amount from my left as I do from my right. As long as your nurse your baby from both sides equally, you're doing everything right.

But definitely see if you can find a lactation consultant who specializes in preemies....they also know a lot about pumping for them.

Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma GandhiLooking for more information about vaccines?